术前输注氟比洛芬酯对开腹子宫切除术患者围术期镇痛效果和血浆细胞因子的影响  

Effect of intravenous injection of lipid microspheres flurbiprofen axetil before abdominal hysterectomy on analgesia and cytokine during perioperative period

作　　者：陈安基[1] 潘道波[1] 周爱国[1] 易善元[1] 王铭初[2] 郭思惠[3] 

机构地区：[1]湖南省常德市第一人民医院麻醉科,湖南常德415003 [2]湖南省常德市第一人民医院中心实验室,湖南常德415003 [3]湖南省常德市第一人民医院核医学科,湖南常德415003

出　　处：《中日友好医院学报》2010年第1期25-28,共4页Journal of China-Japan Friendship Hospital

基　　金：常德市科技局社会发展基金(编号2008sk02)

摘　　要：目的:探讨术前输注氟比洛芬酯(凯纷)对开腹子宫切除术患者围术期镇痛效果和血浆细胞因子的影响。方法:择期行子宫切除术患者60例,ASAI～Ⅱ级,随机分为凯纷组和芬太尼组,每组30例。凯纷组术前5min静脉输注凯纷1mg/kg,芬太尼组术前5min静脉输注芬太尼1μg/kg,术毕2组静脉自控镇痛,锁定时间15min,视觉模拟评分法(VAS)行术后12、24及48h静止和活动评分,分别在开放静脉前(T1)、手术结束时(T2)、术后24h(T3)、术后48h(T4)采取外周静脉血4ml测定血浆白细胞介素-2(IL-2)、IL-6、IL-8、IL-10和TNF-α浓度。结果:2组患者在T2和T3活动时VAS值比较,凯纷组显著低于芬太尼组(均P<0.05);2组患者的血浆IL-2、IL-6、IL-8、IL-10、TNF-α在T2时显著高于T1(均P<0.05);凯纷组患者的血浆IL-2、IL-10在T2、T3和T4时显著高于芬太尼组(均P<0.05);2组患者的血浆IL-6、IL-8在T3时比较差异显著(均P<0.05),凯纷组TNF-α在T3和T4时显著低于芬太尼组(均P<0.05)。结论:开腹子宫切除术患者术前输注凯纷能增强芬太尼围术期镇痛效应和改善机体的免疫功能。Objective：To evaluate the effect of intravenous injection of lipid microspheres flurbiprofen axetil （FA） before abdominal hysterectomy on expression of IL-6,IL-8 and TNF-α during perioperative period. Methods：Sixty selective hysterectomy patients were randomly divided into 2 groups with 30 cases each.FA group,intravenous injection of FA lmg/kg 5 minutes before surgical incision.Fentanyl （F）group,intravenous in- jection fentanyl 1μg/kg 5 minutes before surgical incision.Two groups received patient self-controlled intravenous analgesia for 15min.Pain scales was assessed by visual analog scales（VAS）at 12,24,48h after surgery. Peripheral venous blood samples were respectively taken before anesthesia（T1）,at the end of operation（T2）,at 24th hour（T3）and 48th hour（T4） after operation,and detected the level of IL-2,IL-6,IL-8,IL-10 and TNF-α in the plasma.Results：There was significantly VAS difference of activity at T2 and T3 between groups,FA group was significantly lower than F group （P〈0.05）.Levels of IL-2,IL-6,IL-8,IL-10 and TNF-α in two groups increased the highest at T2,there was significantly difference between T1 and T2 （P〈0.05）.There was significant difference on levels of IL-2,IL-10 between the two groups at T2,T3 and T4 （P〈0.05）,the level of FA group was significantly higher than F group.There was significant difference on levels of IL-6,IL-8 between the two groups at T3 （P〈0.05）.The level of TNF-α in FA group was significantly lower than that of F group at T3 and T4 （P〈0.05）.Conclusion：Intravenous inject FA before hysterectomy can relieve postoperative stress reaction and improve immunologic function.

关 键 词：氟比洛芬酯 开腹子宫切除术 镇痛免疫功能 

分 类 号：R614[医药卫生—麻醉学]